title: Translating 10 lessons from lean six sigma project in paper-based training site to electronic health record-based primary care practice: challenges and opportunities.
abstract: Lean Six Sigma is a well-proven methodology to enhance the performance of any business, including health care. The strategy focuses on cutting out waste and variation from the processes to improve the value and efficiency of work. This article walks through the journey of "green belt" training using a Lean Six Sigma approach and the implementation of a process improvement project that focused on wait time for patients to be examined in an urban academic primary care clinic without requiring added resources. Experiences of the training and the project at an urban paper-based satellite clinic have informed the planning efforts of a data and performance team, including implementing a 15-minute nurse "pre-visit" at primary care sites of an accountable care organization.
authors.affiliation: Geisel School of Medicine and General Internal Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA. sohaib.aleem@hitchcock.org
authors.forename: Sohaib
authors.initials: S
authors.lastname: Aleem
mesh_terms: D060866:Accountable Care Organizations; D003479:Curriculum; D017598:Efficiency, Organizational / Q000191:economics; D057286:Electronic Health Records; D006801:Humans; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration; D017749:Total Quality Management / Q000379:methods*; D019037:Urban Health Services; D014850:Waiting Lists